The Epidemiology of Vibrio Infections in Florida, 1981–1993

Epidemiology Program, Florida Department of Health and Rehabilitative Services, Tallahassee, USA.
The Journal of Infectious Diseases (Impact Factor: 5.78). 06/1996; 173(5):1176-83. DOI: 10.1093/infdis/173.5.1176
Source: PubMed

ABSTRACT The epidemiology of 690 Vibrio infections reported in Florida during 1981-1993 is described. Most infections resulted in one of three clinical syndromes: gastroenteritis (51%), wound infections (24%), or primary septicemia (17%). Case-fatality rates were 1% for gastroenteritis, 5% for wound infections, and 44% for primary septicemia. While gastroenteritis had little seasonal variation, 91% of primary septicemias and 86% of wound infections occurred from April through October, mostly due to the seasonality of Vibrio vulnificus and Vibrio parahaemolyticus infections. Infected wounds were largely a result of occupational activities around seawater. Some 68% of gastroenteritis cases and 83% of the primary septicemias were associated with raw oyster consumption. Preexisting liver disease was present in 48% of patients with primary septicemia and was associated with a fatal outcome in both wound infections (relative risk [RR], 28.3; 95% confidence interval [CI], 6.3-127.5; P < .0001) and primary septicemia (RR, 1.9; 95% CI, 1.2-3.1; P < .01).

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    • "Numerosas infecciones humanas asociadas con Vibrio cholerae no O1 se han reportado mundialmente . Entre ellas se encuentran gastroenteritis, septicemia, bacteriemia, meningitis, infecciones en heridas y oído, especialmente después del consumo de alimentos marinos crudos o mal cocidos o el contacto con el agua de mar (Fernández et al., 2000; Hlady y Klontz, 1996). De ahí la importancia de considerar su presencia en las aguas estudiadas, principalmente las de aguas de consumo y las recreativas. "
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    • "Finally, we must draw the readers' attention to the wide CIs for some of the variables and remind that such intervals do not rule out the possibility that a variable will be significant. Nevertheless, the number of patients with V vulnificus infection in our study is comparable with patient numbers in previously published reports for a study period ranging from 3 to 13 years [1] [2] [3] [4] [5] [6] [7] [8] [11] [12] [13] [32] [33]. "
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    ABSTRACT: The purpose of this study was to explore the predictive factors for mortality in primary septicemia or wound infections caused by Vibrio vulnificus. A retrospective review of 90 patients 18 years and older who were hospitalized due to V vulnificus infection between January 2000 and December 2006 was performed. Clinical characteristics, laboratory studies, treatments, and outcomes retrieved from medical records were analyzed. Multiple logistic regression and receiver operating characteristic curve analyses were performed. Of 90 patients identified as V vulnificus infections, 39 had primary septicemia and 51 had wound infection. The mean age was 63.0 +/- 11.9 years. The mean Acute Physiology and Chronic Health Evaluation (APACHE II) and Mortality in Emergency Department Sepsis (MEDS) scores on admission were 11.1 +/- 4.9 and 5.5 +/- 3.8, respectively. Fifteen patients died, yielding an in-hospital mortality rate of 17%. Multivariate analysis revealed that higher APACHE II (odds ratio, 1.5; 95% confidence interval [CI], 1.2-1.8; P< .0001) and MEDS (odds ratio, 1.3; 95% CI, 1.1-1.6; P = .0201) scores on admission were significantly associated with mortality. The area under the receiver operating characteristic curves values for APACHE II and MEDS in predicting in-hospital mortality were 0.928 (95% CI, 0.854-0.972) and 0.830 (95% CI, 0.736-0.901), respectively. The APACHE II and MEDS scores on admission are significant prognostic indicators in primary septicemia or wound infections caused by V vulnificus. A further prospective study to strengthen this point is required.
    The American journal of emergency medicine 05/2010; 28(4):424-31. DOI:10.1016/j.ajem.2008.12.037 · 1.15 Impact Factor
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    • "The infection can also be acquired through open wounds when exposed to water contaminated with the pathogen. This estuarine bacterium preferentially affects individuals that are heavy drinkers of alcohol and patients with underlying hepatic diseases and other compromised conditions, such as hemochromatosis and beta thalassemia (Hlady and Klontz, 1996; Morris, 1988; Strom and Paranjpye, 2000). The pathogen frequently causes fatal primary septicemia with a very rapid progress, resulting in a mortality rate of more than 50% within a few days (Linkous and Oliver, 1999; Lee et al., 2000; Chiang and Chuang, 2003; Potasman et al., 2002). "
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    ABSTRACT: In Vibrio vulnificus, HlyU upregulates the expression of the large RTX toxin gene. In this work we identified the binding site of HlyU to -417 to -376 bp of the rtxA1 operon transcription start site. lacZ fusions for a series of progressive deletions from the rtxA1 operon promoter showed that transcriptional activity increased independently of HlyU when its binding site was absent. Thus HlyU must regulate the rtxA1 operon expression by antagonizing a negative regulator. Concomitantly we found that an hns mutant resulted in an increase in the expression of the rtxA1 operon genes. Multiple copies of HlyU can increase the promoter activity only in the presence of H-NS underscoring the hypothesis that HlyU must alleviate the repression by this protein. H-NS binds to a region that extends upstream and downstream of the rtxA1 operon promoter. In the upstream region it binds to five AT-rich sites of which two overlap the HlyU binding site. Competitive footprinting and gel shift data demonstrate HlyU's higher affinity as compared with H-NS resulting in the de-repression and a corresponding increased expression of the rtxA1 operon.
    Molecular Microbiology 04/2009; 72(2):491-505. DOI:10.1111/j.1365-2958.2009.06664.x · 5.03 Impact Factor
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